Anal pain

Introduction

Anal pain (pain in the bottom) can be distressing, but is often just the result of a minor, treatable condition.

The medical name for pain in and around the anus or rectum (back passage) is proctalgia.

This pages covers:

Common causes of anal pain

Less common causes of anal pain

When to get medical advice

Common causes of anal pain

Anal fissures

An anal fissure is a small tear in the skin of the anus that can be caused by passing a large or hard poo.

Symptoms of an anal fissure can include:

a severe, sharp pain when doing a poo

a burning or gnawing pain that lasts several hours after doing a poo

rectal bleeding – you may notice a small amount of blood on the toilet paper after you wipe

Anal fissures can be very painful, but many heal on their own in a few weeks. Increasing the amount of fibre in your diet, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.

If the pain persists, you may need special ointment that relaxes the ring of muscle around your anus. Occasionally, surgery may be needed to help the fissure heal.

Haemorrhoids (piles)

Haemorrhoids (piles) are swellings containing enlarged blood vessels that are found inside or around the bottom. They're often thought to be caused by straining on the toilet as a result of prolonged constipation .

In many cases, haemorrhoids don't cause symptoms. When symptoms do occur, they may include:

Anal fistulas and abscesses

An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus. It's usually caused by an infection near the anus resulting in a collection of pus (an abscess ).

Symptoms of an anal fistula or abscess can include:

a constant, throbbing pain that may be worse when you sit down

skin irritation around the anus

passing pus or blood when you poo

swelling and redness around your anus

a high temperature (fever)

Your doctor may prescribe antibiotics if an abscess is picked up early on. If it persists, it may need to be drained in hospital, possibly undergeneral anaesthetic (while you're asleep).

If a fistula develops, surgery will usually be needed because they rarely heal by themselves.